When using therapeutic agents that can cause methemoglobinemia (methHb), which of the following is important to prevent adverse effects?

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Methemoglobin (metHb) is an abnormal form of the molecule, in which the heme-complex normal ferrous iron ion (Fe²⁺) loses an electron and is oxidized to its ferric state (Fe²⁺). In the ferric state, the iron ion cannot combine with O₂. The result is a special form of anemia called methemoglobinemia. As with HbCO, clinical abnormalities come from the associated increased affinity for O₂ and loss of oxygen-binding capacity. The most common cause of methemoglobinemia is the therapeutic use of oxidant medications such as nitric oxide, nitroglycerin, and lidocaine. When using these therapeutic agents, frequent monitoring for metHg is important to weigh the risk against the benefit.

When Using Therapeutic Agents That Can Cause Methemoglobinemia (MethHb), Which